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자석 이물에 의한 위-십이지장 누공 1예

A Case of Gastroduodenal Fistula Caused by Ingested Magnetic Foreign Bodies

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초록

If multiple magnets are ingested, the potential exists for the magnets attracting one another across the gastrointestinal tract and inducing pressure necrosis, perforation, fistula formation, or intestinal obstruction. We report the case of a 12-year-old boy who suffered from a fistulous communication between the lesser curvature of the mid-body of the stomach and the duodenal bulb, caused by 4 ingested magnets (Singing Magnets, China). The patient presented with moderate mental retardation, a one-year history of cyclic vomiting, and abdominal discomfort. We present the findings of simple abdominal radiography, esophagogastroduodenoscopy, computed tomography, and upper gastrointestinal series. An emergency exploratory laparotomy was performed, which revealed a gastroduodenal fistula. Fistula repair and the removal of 4 magnetic toys were subsequently performed. We emphasize that clinicians who care for children should be aware of the hazards of magnetic toy ingestion.

Abstract

If multiple magnets are ingested, the potential exists for the magnets attracting one another across the gastrointestinal tract and inducing pressure necrosis, perforation, fistula formation, or intestinal obstruction. We report the case of a 12-year-old boy who suffered from a fistulous communication between the lesser curvature of the mid-body of the stomach and the duodenal bulb, caused by 4 ingested magnets (Singing Magnets, China). The patient presented with moderate mental retardation, a one-year history of cyclic vomiting, and abdominal discomfort. We present the findings of simple abdominal radiography, esophagogastroduodenoscopy, computed tomography, and upper gastrointestinal series. An emergency exploratory laparotomy was performed, which revealed a gastroduodenal fistula. Fistula repair and the removal of 4 magnetic toys were subsequently performed. We emphasize that clinicians who care for children should be aware of the hazards of magnetic toy ingestion.

참고문헌 (13)

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  8. Kwak BG, "Small Bowel-mesentery-small bowel fistula caused by ingested magnets", J Pediatir Gastroenterol Nutr, 8(1), pp.60~63 (2005)
  9. Hwang JB, "How strong construction toy magnets are! A gastro-gastro- duodenal fistula formation", J Pediatir Gastroenterol Nutr, 44, pp.291~292 (2007)
  10. "Gastrointestinal injuries from magnet ingestion in children- United States, 2003-2006", MMWR Morb Mortal Wkly Rep, 55, pp.1296~1300 (2006), Centers for Disease Control and Prevention (CDC)
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